Professor of Radiology (Molecular Imaging Program at Stanford/Nuclear Medicine) and, by courtesy, of Physics, of Electrical Engineering and of Bioengineering

Radiology - Rad/Molecular Imaging Program at Stanford

Bio

Bio

Professor Levin's research interests involve the development of novel instrumentation and software algorithms for in vivo imaging of molecular signatures of disease in humans and small laboratory animals. These new cameras efficiently image radiation emissions in the form of positrons, annihilation photons, gamma rays, and light from molecular probes developed to target molecular signals from deep within tissue of live subjects.The goals of the instrumentation projects are to advance the sensitivity and spatial, spectral, and/or temporal resolutions. The algorithm goals are to understand the physical system comprising the subject tissues, radiation transport, and imaging system, and to provide the best available image quality and quantitative accuracy.The work involves computer modeling, position sensitive sensors, readout electronics, data acquisition, image formation, image processing, and data/image analysis algorithms, and incorporating these innovations into practical imaging devicesThe ultimate goal is to introduce these new imaging tools into studies of molecular mechanisms and new treatments of disease within living subjects.

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Research & Scholarship

Current Research and Scholarly Interests

Molecular Imaging Instrumentation Laboratory

Our research interests involve the development of novel instrumentation and software algorithms for in vivo imaging of cellular and molecular signatures of disease in humans and small laboratory animal subjects. These new cameras efficiently image radiation emissions in the form of positrons, annihilation photons, gamma rays, and light from molecular probes developed to target molecular signals from deep within tissue of live subjects. The goals of the instrumentation projects are to push the sensitivity and spatial, spectral, and/or temporal resolutions as far as physically possible. The algorithm goals are to understand the physical system comprising the subject tissues, radiation transport, and imaging system, and to provide the best available image quality and quantitative accuracy. The work involves computer modeling, position sensitive sensors, readout electronics, data acquisition, image formation, image processing, and data/image analysis algorithms, and incorporating these innovations into practical imaging devices. The ultimate goal is to introduce these new imaging tools into studies of molecular mechanisms and treatments of disease within living subjects.

Clinical Trials

Lymphoscintigraphy is an accepted and commonly performed procedure used for staging of
certain cancers, especially melanoma and breast cancer. It involves injecting a small amount
of radioactivity under the skin in order to identify lymph nodes which should be biopsied
(i.e., the "sentinel node") to determine if cancer has spread. Our objective is to evaluate
the potential benefit of a new, camera-based technology which allows actual images to be
obtained intraoperatively in the identification of sentinel nodes.

Stanford is currently not accepting patients for this trial.For more information, please contact Mike YaO, (312) 543 - 5207.

Abstract

Our objective was to determine clinically the value of time-of-flight (TOF) information in reducing PET artifacts and improving PET image quality and accuracy in simultaneous TOF PET/MR scanning.A total 65 patients who underwent a comparative scan in a simultaneous TOF PET/MR scanner were included. TOF and non-TOF PET images were reconstructed, clinically examined, compared and scored. PET imaging artifacts were categorized as large or small implant-related artifacts, as dental implant-related artifacts, and as implant-unrelated artifacts. Differences in image quality, especially those related to (implant) artifacts, were assessed using a scale ranging from 0 (no artifact) to 4 (severe artifact).A total of 87 image artifacts were found and evaluated. Four patients had large and eight patients small implant-related artifacts, 27 patients had dental implants/fillings, and 48 patients had implant-unrelated artifacts. The average score was 1.14 ± 0.82 for non-TOF PET images and 0.53 ± 0.66 for TOF images (p?0.01) indicating that artifacts were less noticeable when TOF information was included.Our study indicates that PET image artifacts are significantly mitigated with integration of TOF information in simultaneous PET/MR. The impact is predominantly seen in patients with significant artifacts due to metal implants.

Abstract

It is well known that a PET detector capable of measuring both photon time-of-flight (TOF) and depth-of-interaction (DOI) improves the image quality and accuracy. Phoswich designs have been realized in PET detectors to measure DOI for more than a decade. However, PET detectors based on phoswich designs put great demand on the readout circuits, which have to differentiate the pulse shape produced by different crystal layers. A simple pulse shape discrimination approach is required to realize the phoswich designs in a clinical PET scanner, which consists of thousands of scintillation crystal elements. In this work, we studied time-over-threshold (ToT) as a pulse shape parameter for DOI. The energy, timing and DOI performance were evaluated for a phoswich detector design comprising [Formula: see text] mm LYSO:Ce crystal optically coupled to [Formula: see text] mm calcium co-doped LSO:Ce,Ca(0.4%) crystal read out by a silicon photomultiplier (SiPM). A DOI accuracy of 97.2% has been achieved for photopeak events using the proposed time-over-threshold (ToT) processing. The energy resolution without correction for SiPM non-linearity was [Formula: see text]% and [Formula: see text]% FWHM at 511?keV for LYSO and LSO crystal layers, respectively. The coincidence time resolution for photopeak events ranges from 164.6?ps to 183.1?ps FWHM, depending on the layer combinations. The coincidence time resolution for inter-crystal scatter events ranges from 214.6?ps to 418.3?ps FWHM, depending on the energy windows applied. These results show great promises of using ToT for pulse shape discrimination in a TOF phoswich detector since a ToT measurement can be easily implemented in readout electronics.

Abstract

We compare the performance of two detector materials, cadmium telluride (CdTe) and bismuth silicon oxide (BSO), for optical property modulation-based radiation detection method for positron emission tomography (PET), which is a potential new direction to dramatically improve the annihilation photon pair coincidence time resolution. We have shown that the induced current flow in the detector crystal resulting from ionizing radiation determines the strength of optical modulation signal. A larger resistivity is favorable for reducing the dark current (noise) in the detector crystal, and thus the higher resistivity BSO crystal has a lower (50% lower on average) noise level than CdTe. The CdTe and BSO crystals can achieve the same sensitivity under laser diode illumination at the same crystal bias voltage condition while the BSO crystal is not as sensitive to 511-keV photons as the CdTe crystal under the same crystal bias voltage. The amplitude of the modulation signal induced by 511-keV photons in BSO crystal is around 30% of that induced in CdTe crystal under the same bias condition. In addition, we have found that the optical modulation strength increases linearly with crystal bias voltage before saturation. The modulation signal with CdTe tends to saturate at bias voltages higher than 1500 V due to its lower resistivity (thus larger dark current) while the modulation signal strength with BSO still increases after 3500 V. Further increasing the bias voltage for BSO could potentially further enhance the modulation strength and thus, the sensitivity.

Abstract

A brain sized radio frequency (RF)-penetrable PET insert has been designed for simultaneous operation with MRI systems. This system takes advantage of electro-optical coupling and battery power to electrically float the PET insert relative to the MRI ground, permitting RF signals to be transmitted through small gaps between the modules that form the PET ring. This design facilitates the use of the built-in body coil for RF transmission and thus could be inserted into any existing MR site wishing to achieve simultaneous PET/MR imaging. The PET detectors employ nonmagnetic silicon photomultipliers in conjunction with a compressed sensing signal multiplexing scheme, and optical fibers to transmit analog PET detector signals out of the MRI room for decoding, processing, and image reconstruction.The PET insert was first constructed and tested in a laboratory benchtop setting, where tomographic images of a custom resolution phantom were successfully acquired. The PET insert was then placed within a 3T body MRI system, and tomographic resolution/contrast phantom images were acquired both with only the B0 field present, and under continuous pulsing from different MR imaging sequences.The resulting PET images have comparable contrast-to-noise ratios (CNR) under all MR pulsing conditions: The maximum percent CNR relative difference for each rod type among all four PET images acquired in the MRI system has a mean of 14.0 ± 7.7%. MR images were successfully acquired through the RF-penetrable PET shielding using only the built-in MR body coil, suggesting that simultaneous imaging is possible without significant mutual interference.These results show promise for this technology as an alternative to costly integrated PET/MR scanners; a PET insert that is compatible with any existing clinical MRI system could greatly increase the availability, accessibility, and dissemination of PET/MR.

Abstract

Maintaining excellent timing resolution in the generation of silicon photomultiplier (SiPM)-based time-of-flight positron emission tomography (TOF-PET) systems requires a large number of high-speed, high-bandwidth electronic channels and components. To minimize the cost and complexity of a system's back-end architecture and data acquisition, many analog signals are often multiplexed to fewer channels using techniques that encode timing, energy, and position information. With progress in the development SiPMs having lower dark noise, after pulsing, and cross talk along with higher photodetection efficiency, a coincidence timing resolution (CTR) well below 200 ps FWHM is now easily achievable in single pixel, bench-top setups using 20-mm length, lutetium-based inorganic scintillators. However, multiplexing the output of many SiPMs to a single channel will significantly degrade CTR without appropriate signal processing. We test the performance of a PET detector readout concept that multiplexes 16 SiPMs to two channels. One channel provides timing information with fast comparators, and the second channel encodes both position and energy information in a time-over-threshold-based pulse sequence. This multiplexing readout concept was constructed with discrete components to process signals from a [Formula: see text] array of SensL MicroFC-30035 SiPMs coupled to [Formula: see text] Lu1.8Gd0.2SiO5 (LGSO):Ce (0.025 mol. %) scintillators. This readout method yielded a calibrated, global energy resolution of 15.3% FWHM at 511 keV with a CTR of [Formula: see text] FWHM between the 16-pixel multiplexed detector array and a [Formula: see text] LGSO-SiPM reference detector. In summary, results indicate this multiplexing scheme is a scalable readout technique that provides excellent coincidence timing performance.

Abstract

The next generation of discoveries in molecular imaging requires positron emission tomography (PET) systems with high spatial resolution and high sensitivity to visualize and quantify low concentrations of molecular probes. The goal of this work is to assemble and explore such a system. We use cadmium zinc telluride (CZT) to achieve high spatial resolution, three-dimensional interaction positioning, and excellent energy resolution. The CZT crystals are arranged in an edge-on configuration with a minimum gap of [Formula: see text] in a four-sided panel geometry to achieve superior photon sensitivity. The developed CZT detectors and readout electronics were scaled up to complete significant portions of the final PET system. The steering electrode bias and the amplitude of the analog signals for time measurement were optimized to improve performance. The energy resolution (at 511 keV) over 468 channels is [Formula: see text] full-width-at-half-maximum (FWHM). The spatial resolution is [Formula: see text] FWHM. The time resolution of six CZT crystals in coincidence with six other CZT crystals is 37 ns. With high energy and spatial resolution and the relatively low random rate for small animal imaging, this system shows promise to be very useful for molecular imaging studies.

Abstract

Time of flight (TOF) and depth of interaction (DOI) capabilities can significantly enhance the quality and uniformity of positron emission tomography (PET) images. Many proposed TOF/DOI PET detectors require complex readout systems using additional photosensors, active cooling, or waveform sampling. This work describes a high performance, low complexity, room temperature TOF/DOI PET module. The module uses multiplexed timing channels to significantly reduce the electronic readout complexity of the PET detector while maintaining excellent timing, energy, and position resolution. DOI was determined using a two layer light sharing scintillation crystal array with a novel binary position sensitive network. A 20?mm effective thickness LYSO crystal array with four 3?mm??×??3?mm silicon photomultipliers (SiPM) read out by a single timing channel, one energy channel and two position channels achieved a full width half maximum (FWHM) coincidence time resolution of 180??±??2?ps with 10?mm of DOI resolution and 11% energy resolution. With sixteen 3?mm??×??3?mm SiPMs read out by a single timing channel, one energy channel and four position channels a coincidence time resolution 204??±??1?ps was achieved with 10?mm of DOI resolution and 15% energy resolution. The methods presented here could significantly simplify the construction of high performance TOF/DOI PET detectors.

Abstract

Using conventional scintillation detection, the fundamental limit in positron emission tomography (PET) time resolution is strongly dependent on the inherent temporal variances generated during the scintillation process, yielding an intrinsic physical limit for the coincidence time resolution of around 100?ps. On the other hand, modulation mechanisms of the optical properties of a material exploited in the optical telecommunications industry can be orders of magnitude faster. In this paper we borrow from the concept of optics pump-probe measurement to for the first time study whether ionizing radiation can produce modulations of optical properties, which can be utilized as a novel method for radiation detection. We show that a refractive index modulation of approximately [Formula: see text] is induced by interactions in a cadmium telluride (CdTe) crystal from a 511?keV photon source. Furthermore, using additional radionuclide sources, we show that the amplitude of the optical modulation signal varies linearly with both the detected event rate and average photon energy of the radiation source.

Abstract

Cadmium zinc telluride (CZT) offers key advantages for small animal positron emission tomography (PET), including high spatial and energy resolution and simple metal deposition for fabrication of very small pixel arrays. Previous studies have investigated the intrinsic spatial, energy, and timing resolution of an individual sub-millimeter resolution CZT detector. In this work we present the first characterization results of a system of these detectors. The 3D position sensitive dual-CZT detector module and readout electronics developed in our lab was scaled up to complete a significant portion of the final PET system. This sub-system was configured as two opposing detection panels containing a total of twelve [Formula: see text] mm monolithic CZT crystals for proof of concept. System-level characterization studies, including optimizing the trigger threshold of each channel's comparators, were performed. (68)Ge and (137)Cs radioactive isotopes were used to characterize the energy resolution of all 468 anode channels in the sub-system. The mean measured global 511?keV photopeak energy resolution over all anodes was found to be [Formula: see text]% FWHM after correction for photon interaction depth-dependent signal variation. The measured global time resolution was 37 ns FWHM, a parameter to be further optimized, and the intrinsic spatial resolution was 0.76?mm FWHM.

Abstract

Multiplexing many SiPMs to a single readout channel is an attractive option to reduce the readout complexity of high performance time of flight (TOF) PET systems. However, the additional dark counts and shaping from each SiPM cause significant baseline fluctuations in the output waveform, degrading timing measurements using a leading edge threshold. This work proposes the use of a simple analog filtering network to reduce the baseline fluctuations in highly multiplexed SiPM readouts. With 16 SiPMs multiplexed, the FWHM coincident timing resolution for single [Formula: see text] mm LYSO crystals was improved from 401??±??4 ps without filtering to 248??±??5 ps with filtering. With 4 SiPMs multiplexed, using an array of [Formula: see text] mm LFS crystals the mean time resolution was improved from 436??±??6 ps to 249??±??2 ps. Position information was acquired with a novel binary positioning network. All experiments were performed at room temperature with no active temperature regulation. These results show a promising technique for the construction of high performance multiplexed TOF PET readout systems using analog leading edge timing pickoff.

Abstract

A recent entry into the rapidly evolving field of integrated PET/MR scanners is presented in this paper: a whole body hybrid PET/MR system (SIGNA PET/MR, GE Healthcare) capable of simultaneous acquisition of both time-of-flight (TOF) PET and high resolution MR data. The PET ring was integrated into an existing 3T MR system resulting in a (patient) bore opening of 60 cm diameter, with a 25 cm axial FOV. PET performance was evaluated both on the standalone PET ring and on the same detector integrated into the MR system, to assess the level of mutual interference between both subsystems. In both configurations we obtained detector performance data. PET detector performance was not significantly affected by integration into the MR system. The global energy resolution was within 2% (10.3% versus 10.5%), and the system coincidence time resolution showed a maximum change of < 3% (385 ps versus 394 ps) when measured outside MR and during simultaneous PET/MRI acquisitions, respectively. To evaluate PET image quality and resolution, the NEMA IQ phantom was acquired with MR idle and with MR active. Impact of PET on MR IQ was assessed by comparing SNR with PET acquisition on and off. B0 and B1 homogeneities were acquired before and after the integration of the PET ring inside the magnet. In vivo brain and whole body head-to-thighs data were acquired to demonstrate clinical image quality.

Abstract

The GE SIGNA PET/MR is a new whole body integrated time-of-flight (ToF)-PET/MR scanner from GE Healthcare. The system is capable of simultaneous PET and MR image acquisition with sub-400 ps coincidence time resolution. Simultaneous PET/MR holds great potential as a method of interrogating molecular, functional, and anatomical parameters in clinical disease in one study. Despite the complementary imaging capabilities of PET and MRI, their respective hardware tends to be incompatible due to mutual interference. In this work, the GE SIGNA PET/MR is evaluated in terms of PET performance and the potential effects of interference from MRI operation.The NEMA NU 2-2012 protocol was followed to measure PET performance parameters including spatial resolution, noise equivalent count rate, sensitivity, accuracy, and image quality. Each of these tests was performed both with the MR subsystem idle and with continuous MR pulsing for the duration of the PET data acquisition. Most measurements were repeated at three separate test sites where the system is installed.The scanner has achieved an average of 4.4, 4.1, and 5.3 mm full width at half maximum radial, tangential, and axial spatial resolutions, respectively, at 1 cm from the transaxial FOV center. The peak noise equivalent count rate (NECR) of 218 kcps and a scatter fraction of 43.6% are reached at an activity concentration of 17.8 kBq/ml. Sensitivity at the center position is 23.3 cps/kBq. The maximum relative slice count rate error below peak NECR was 3.3%, and the residual error from attenuation and scatter corrections was 3.6%. Continuous MR pulsing had either no effect or a minor effect on each measurement.Performance measurements of the ToF-PET whole body GE SIGNA PET/MR system indicate that it is a promising new simultaneous imaging platform.

Abstract

Using time of flight (ToF) measurements for positron emission tomography (PET) is an attractive avenue for increasing the signal to noise (SNR) ratio of PET images. However, achieving excellent time resolution required for high SNR gain using silicon photomultipliers (SiPM) requires many resource heavy high bandwidth readout channels. A method of multiplexing many SiPM signals into a single electronic channel would greatly simplify ToF PET systems. However, multiplexing SiPMs degrades time resolution because of added dark counts and signal shaping. In this work the relative contribution of dark counts and signal shaping to timing degradation is simulated and a baseline correction technique to mitigate the effect of multiplexing on the time resolution of analog SiPMs is simulated and experimentally verified. A charge sharing network for multiplexing is proposed and tested. Results show a full width at half maximum (FWHM) coincidence time resolution of [Formula: see text] ps for a single 3?mm??×??3?mm??×??20?mm LYSO scintillation crystals coupled to an array of sixteen 3?mm??×??3?mm SiPMs that are multiplexed to a single timing channel (in addition to 4 position channels). A [Formula: see text] array of 3?mm??×??3?mm??×??20?mm LFS crystals showed an average FWHM coincidence time resolution of [Formula: see text] ps using the same timing scheme. All experiments were performed at room temperature with no thermal regulation. These results show that excellent time resolution for ToF can be achieved with a highly multiplexed analog SiPM readout.

Abstract

Coincidence time resolution (CTR), an important parameter for time-of-flight (TOF) PET performance, is determined mainly by properties of the scintillation crystal and photodetector used. Stable production techniques for LGSO:Ce (Lu1.8Gd0.2SiO5:Ce) with decay times varying from???30-40 ns have been established over the past decade, and the decay time can be accurately controlled with varying cerium concentration (0.025-0.075 mol%). This material is promising for TOF-PET, as it has similar light output and equivalent stopping power for 511 keV annihilation photons compared to industry standard LSO:Ce and LYSO:Ce, and the decay time is improved by more than 30% with proper Ce concentration. This work investigates the achievable CTR with LGSO:Ce (0.025 mol%) when coupled to new silicon photomultipliers. Crystal element dimension is another important parameter for achieving fast timing. 20?mm length crystal elements achieve higher 511 keV photon detection efficiency, but also introduce higher scintillation photon transit time variance. 3?mm length crystals are not practical for PET, but have reduced scintillation transit time spread. The CTR between pairs of [Formula: see text] mm(3)and [Formula: see text] mm(3) LGSO:Ce crystals was measured to be [Formula: see text] and [Formula: see text] ps FWHM, respectively. Measurements of light yield and intrinsic decay time are also presented for a thorough investigation into the timing performance with LGSO:Ce (0.025 mol%).

Abstract

Breast-dedicated radionuclide imaging systems show promise for increasing clinical sensitivity for breast cancer while minimizing patient dose and cost. We present several breast-dedicated coincidence-photon and single-photon camera designs that have been described in the literature and examine their intrinsic performance, clinical relevance, and impact. Recent tracer development is mentioned, results from recent clinical tests are summarized, and potential areas for improvement are highlighted.

Abstract

In the field of information theory, compressed sensing (CS) had been developed to recover signals at a lower sampling rate than suggested by the Nyquist-Shannon theorem, provided the signals have a sparse representation with respect to some base. CS has recently emerged as a method to multiplex PET detector readouts thanks to the sparse nature of 511 keV photon interactions in a typical PET study. We have shown in our previous numerical studies that, at the same multiplexing ratio, CS achieves higher signal-to-noise ratio (SNR) compared to Anger and cross-strip multiplexing. In addition, unlike Anger logic, multiplexing by CS preserves the capability to resolve multi-hit events, in which multiple pixels are triggered within the resolving time of the detector. In this work, we characterized the time, energy and intrinsic spatial resolution of two CS detectors and a data acquisition system we have developed for a PET insert system for simultaneous PET/MRI. The CS detector comprises a [Formula: see text] mosaic of [Formula: see text] arrays of [Formula: see text] mm(3) lutetium-yttrium orthosilicate crystals coupled one-to-one to eight [Formula: see text] silicon photomultiplier arrays. The total number of 128 pixels is multiplexed down to 16 readout channels by CS. The energy, coincidence time and intrinsic spatial resolution achieved by two CS detectors were [Formula: see text]% FWHM at 511 keV, 4.5 ns FWHM and 2.3?mm FWHM, respectively. A series of experiments were conducted to measure the sources of time jitter that limit the time resolution of the current system, which provides guidance for potential system design improvements. These findings demonstrate the feasibility of compressed sensing as a promising multiplexing method for PET detectors.

Abstract

The large number of detector channels in modern positron emission tomography (PET) scanners poses a challenge in terms of readout electronics complexity. Multiplexing schemes are typically implemented to reduce the number of physical readout channels, but often result in performance degradation. Novel methods of multiplexing in PET must be developed to avoid this data degradation. The preservation of fast timing information is especially important for time-of-flight PET.A new multiplexing scheme based on encoding detector interaction events with a series of extremely fast overlapping optical pulses with precise delays is demonstrated in this work. Encoding events in this way potentially allows many detector channels to be simultaneously encoded onto a single optical fiber that is then read out by a single digitizer. A two channel silicon photomultiplier-based prototype utilizing this optical delay encoding technique along with dual threshold time-over-threshold is demonstrated.The optical encoding and multiplexing prototype achieves a coincidence time resolution of 160 ps full width at half maximum (FWHM) and an energy resolution of 13.1% FWHM at 511 keV with 3 × 3 × 5 mm(3) LYSO crystals. All interaction information for both detectors, including timing, energy, and channel identification, is encoded onto a single optical fiber with little degradation.Optical delay encoding and multiplexing technology could lead to time-of-flight PET scanners with fewer readout channels and simplified data acquisition systems.

Abstract

Excellent timing resolution is required to enhance the signal-to-noise ratio (SNR) gain available from the incorporation of time-of-flight (ToF) information in image reconstruction for positron emission tomography (PET). As the detector's timing resolution improves, so does SNR, reconstructed image quality, and accuracy. This directly impacts the challenging detection and quantification tasks in the clinic. The recognition of these benefits has spurred efforts within the molecular imaging community to determine to what extent the timing resolution of scintillation detectors can be improved and develop near-term solutions for advancing ToF-PET. Presented in this work, is a method for calculating the Cramér-Rao lower bound (CRLB) on timing resolution for scintillation detectors with long crystal elements, where the influence of the variation in optical path length of scintillation light on achievable timing resolution is non-negligible. The presented formalism incorporates an accurate, analytical probability density function (PDF) of optical transit time within the crystal to obtain a purely mathematical expression of the CRLB with high-aspect-ratio (HAR) scintillation detectors. This approach enables the statistical limit on timing resolution performance to be analytically expressed for clinically-relevant PET scintillation detectors without requiring Monte Carlo simulation-generated photon transport time distributions. The analytically calculated optical transport PDF was compared with detailed light transport simulations, and excellent agreement was found between the two. The coincidence timing resolution (CTR) between two [Formula: see text] mm[Formula: see text] LYSO:Ce crystals coupled to analogue SiPMs was experimentally measured to be [Formula: see text] ps FWHM, approaching the analytically calculated lower bound within 6.5%.

Abstract

The simultaneous acquisition of PET and MRI data shows promise to provide powerful capabilities to study disease processes in human subjects, guide the development of novel treatments, and monitor therapy response and disease progression. A brain-size PET detector ring insert for an MRI system is being developed that, if successful, can be inserted into any existing MRI system to enable simultaneous PET and MRI images of the brain to be acquired without mutual interference. The PET insert uses electro-optical coupling to relay all the signals from the PET detectors out of the MRI system using analog modulated lasers coupled to fiber optics. Because the fibers use light instead of electrical signals, the PET detector can be electrically decoupled from the MRI making it partially transmissive to the RF field of the MRI. The SiPM devices and low power lasers were powered using non-magnetic MRI compatible batteries. Also, the number of laser-fiber channels in the system was reduced using techniques adapted from the field of compressed sensing. Using the fact that incoming PET data is sparse in time and space, electronic circuits implementing constant weight codes uniquely encode the detector signals in order to reduce the number of electro-optical readout channels by 8-fold. Two out of a total of sixteen electro-optical detector modules have been built and tested with the entire RF-shielded detector gantry for the PET ring insert. The two detectors have been tested outside and inside of a 3T MRI system to study mutual interference effects and simultaneous performance with MRI. Preliminary results show that the PET insert is feasible for high resolution simultaneous PET/MRI imaging for applications in the brain.

Abstract

The design of combined positron emission tomography/magnetic resonance (PET/MR) systems presents a number of challenges to engineers, as it forces the PET system to acquire data in a space constrained environment that is sensitive to electro-magnetic interference and contains high static, radio frequency and gradient fields. In this work we validate fast timing performance of a PET scintillation detector using a potentially very compact, very low power, and MR compatible readout method in which analog silicon photomultipliers (SiPM) signals are transmitted optically away from the MR bore with little or even no additional readout electronics. This analog 'electro-optial' method could reduce the entire PET readout in the MR bore to two compact, low power components (SiPMs and lasers). Our experiments show fast timing performance from analog electro-optical readout with and without pre-amplification. With 3 mm × 3 mm × 20 mm lutetium-yttrium oxyorthosilicate (LYSO) crystals and Excelitas SiPMs the best two-sided fwhm coincident timing resolution achieved was 220 +/- 3 ps in electrical mode, 230 +/- 2 ps in electro-optical with preamp mode, and 253 +/- 2 ps in electro-optical without preamp mode. Timing measurements were also performed with Hamamatsu SiPMs and 3 mm × 3 mm × 5 mm crystals. In the future the timing degradation seen can be further reduced with lower laser noise or improvements SiPM rise time or gain.

Abstract

Medical imaging systems are composed of a large number of position sensitive radiation detectors to provide high resolution imaging. For example, whole-body Positron Emission Tomography (PET) systems are typically composed of thousands of scintillation crystal elements, which are coupled to photosensors. Thus, PET systems greatly benefit from methods to reduce the number of data acquisition channels, in order to reduce the system development cost and complexity. In this paper we present an electrical delay line multiplexing scheme that can significantly reduce the number of readout channels, while preserving the signal integrity required for good time resolution performance. We experimented with two 4 × 4 LYSO crystal arrays, with crystal elements having 3 mm × 3 mm × 5 mm and 3 mm × 3 mm × 20 mm dimensions, coupled to 16 Hamamatsu MPPC S10931-050P SiPM elements. Results show that each crystal could be accurately identified, even in the presence of scintillation light sharing and inter-crystal Compton scatter among neighboring crystal elements. The multiplexing configuration degraded the coincidence timing resolution from ?243 ps FWHM to ?272 ps FWHM when 16 SiPM signals were combined into a single channel for the 4 × 4 LYSO crystal array with 3 mm × 3 mm × 20 mm crystal element dimensions, in coincidence with a 3 mm × 3 mm × 5 mm LYSO crystal pixel. The method is flexible to allow multiplexing configurations across different block detectors, and is scalable to an entire ring of detectors.

Abstract

The recent introduction of hybrid PET/MRI scanners in clinical practice has shown promising initial results for several clinical scenarios. However, the first generation of combined PET/MRI lacks time-of-flight (TOF) technology. Here we report the results of the first patients to be scanned on a completely novel fully integrated PET/MRI scanner with TOF.We analyzed data from patients who underwent a clinically indicated F FDG PET/CT, followed by PET/MRI. Maximum standardized uptake values (SUVmax) were measured from F FDG PET/MRI and F FDG PET/CT for lesions, cerebellum, salivary glands, lungs, aortic arch, liver, spleen, skeletal muscle, and fat. Two experienced radiologists independently reviewed the MR data for image quality.Thirty-six patients (19 men, 17 women, mean [±standard deviation] age of 61 ± 14 years [range: 27-86 years]) with a total of 69 discrete lesions met the inclusion criteria. PET/CT images were acquired at a mean (±standard deviation) of 74 ± 14 minutes (range: 49-100 minutes) after injection of 10 ± 1 mCi (range: 8-12 mCi) of F FDG. PET/MRI scans started at 161 ± 29 minutes (range: 117 - 286 minutes) after the F FDG injection. All lesions identified on PET from PET/CT were also seen on PET from PET/MRI. The mean SUVmax values were higher from PET/MRI than PET/CT for all lesions. No degradation of MR image quality was observed.The data obtained so far using this investigational PET/MR system have shown that the TOF PET system is capable of excellent performance during simultaneous PET/MR with routine pulse sequences. MR imaging was not compromised. Comparison of the PET images from PET/CT and PET/MRI show no loss of image quality for the latter. These results support further investigation of this novel fully integrated TOF PET/MRI instrument.

Abstract

Silicon photodetectors are of significant interest for use in positron emission tomography (PET) systems due to their compact size, insensitivity to magnetic fields, and high quantum efficiency. However, one of their main disadvantages is fluctuations in temperature cause strong shifts in gain of the devices. PET system designs with high photodetector density suffer both increased thermal density and constrained options for thermally regulating the devices. This paper proposes a method of thermally regulating densely packed silicon photodetectors in the context of a 1 mm(3) resolution, high-sensitivity PET camera dedicated to breast imaging.The PET camera under construction consists of 2304 units, each containing two 8 × 8 arrays of 1 mm(3) LYSO crystals coupled to two position sensitive avalanche photodiodes (PSAPD). A subsection of the proposed camera with 512 PSAPDs has been constructed. The proposed thermal regulation design uses water-cooled heat sinks, thermoelectric elements, and thermistors to measure and regulate the temperature of the PSAPDs in a novel manner. Active cooling elements, placed at the edge of the detector stack due to limited access, are controlled based on collective leakage current and temperature measurements in order to keep all the PSAPDs at a consistent temperature. This thermal regulation design is characterized for the temperature profile across the camera and for the time required for cooling changes to propagate across the camera. These properties guide the implementation of a software-based, cascaded proportional-integral-derivative control loop that controls the current through the Peltier elements by monitoring thermistor temperature and leakage current. The stability of leakage current, temperature within the system using this control loop is tested over a period of 14 h. The energy resolution is then measured over a period of 8.66 h. Finally, the consistency of PSAPD gain between independent operations of the camera over 10 days is tested.The PET camera maintains a temperature of 18.00 ± 0.05?°C over the course of 12 h while the ambient temperature varied 0.61?°C, from 22.83 to 23.44?°C. The 511 keV photopeak energy resolution over a period of 8.66 h is measured to be 11.3% FWHM with a maximum photopeak fluctuation of 4 keV. Between measurements of PSAPD gain separated by at least 2 day, the maximum photopeak shift was 6 keV.The proposed thermal regulation scheme for tightly packed silicon photodetectors provides for stable operation of the constructed subsection of a PET camera over long durations of time. The energy resolution of the system is not degraded despite shifts in ambient temperature and photodetector heat generation. The thermal regulation scheme also provides a consistent operating environment between separate runs of the camera over different days. Inter-run consistency allows for reuse of system calibration parameters from study to study, reducing the time required to calibrate the system and hence to obtain a reconstructed image.

Abstract

Side readout of scintillation light from crystal elements in positron emission tomography (PET) is an alternative to conventional end-readout configurations, with the benefit of being able to provide accurate depth-of-interaction (DOI) information and good energy resolution while achieving excellent timing resolution required for time-of-flight PET. This paper explores different readout geometries of scintillation crystal elements with the goal of achieving a detector that simultaneously achieves excellent timing resolution, energy resolution, spatial resolution, and photon sensitivity.The performance of discrete LYSO scintillation elements of different lengths read out from the end/side with digital silicon photomultipliers (dSiPMs) has been assessed.Compared to 3 × 3 × 20 mm(3) LYSO crystals read out from their ends with a coincidence resolving time (CRT) of 162 ± 6 ps FWHM and saturated energy spectra, a side-readout configuration achieved an excellent CRT of 144 ± 2 ps FWHM after correcting for timing skews within the dSiPM and an energy resolution of 11.8% ± 0.2% without requiring energy saturation correction. Using a maximum likelihood estimation method on individual dSiPM pixel response that corresponds to different 511 keV photon interaction positions, the DOI resolution of this 3 × 3 × 20 mm(3) crystal side-readout configuration was computed to be 0.8 mm FWHM with negligible artifacts at the crystal ends. On the other hand, with smaller 3 × 3 × 5 mm(3) LYSO crystals that can also be tiled/stacked to provide DOI information, a timing resolution of 134 ± 6 ps was attained but produced highly saturated energy spectra.The energy, timing, and DOI resolution information extracted from the side of long scintillation crystal elements coupled to dSiPM have been acquired for the first time. The authors conclude in this proof of concept study that such detector configuration has the potential to enable outstanding detector performance in terms of timing, energy, and DOI resolution.

Abstract

In this work, a method is presented that can calculate the lower bound of the timing resolution for large scintillation crystals with non-negligible photon transport. Hereby, the timing resolution bound can directly be calculated from Monte Carlo generated arrival times of the scintillation photons. This method extends timing resolution bound calculations based on analytical equations, as crystal geometries can be evaluated that do not have closed form solutions of arrival time distributions. The timing resolution bounds are calculated for an exemplary 3 mm × 3 mm × 20 mm LYSO crystal geometry, with scintillation centers exponentially spread along the crystal length as well as with scintillation centers at fixed distances from the photosensor. Pulse shape simulations further show that analog photosensors intrinsically operate near the timing resolution bound, which can be attributed to the finite single photoelectron pulse rise time.

Abstract

We are developing a 1?mm(3) resolution positron emission tomography camera dedicated to breast imaging. The camera collects high energy photons emitted from radioactively labeled agents introduced in the patients in order to detect molecular signatures of breast cancer. The camera comprises many layers of lutetium yttrium oxyorthosilicate (LYSO) scintillation crystals coupled to position sensitive avalanche photodiodes (PSAPDs). The main objectives of the studies presented in this paper are to investigate the temperature profile of the layers of LYSO-PSAPD detectors (a.k.a. 'fins') residing in the camera and to use these results to present the design of the thermal regulation system for the front end of the camera. The study was performed using both experimental methods and simulation. We investigated a design with a heat-dissipating fin. Three fin configurations are tested: fin with Al windows (FwW), fin without Al windows (FwoW) and fin with alumina windows (FwAW). A Fluent® simulation was conducted to study the experimentally inaccessible temperature of the PSAPDs. For the best configuration (FwW), the temperature difference from the center to a point near the edge is 1.0?K when 1.5 A current was applied to the Peltier elements. Those of FwoW and FwAW are 2.6?K and 1.7?K, respectively. We conclude that the design of a heat-dissipating fin configuration with 'aluminum windows' (FwW) that borders the scintillation crystal arrays of 16 adjacent detector modules has better heat dissipation capabilities than the design without 'aluminum windows' (FwoW) and the design with 'alumina windows' (FwAW), respectively.

Abstract

Time-over-threshold (ToT) is attractive as a method of combined timing and energy encoding in positron emission tomography (PET) due to its simplicity in implementation and readout. However, conventional single threshold ToT has a nonlinear response and generally suffers from a tradeoff between timing and energy resolution. The resulting poor performance is not fit for applications requiring fast timing, such as time-of-flight (ToF) PET. In this work it is shown experimentally that by replacing single threshold ToT with a dual threshold method in a new compact circuit, excellent time resolution can be achieved (154 ps FWHM for 3 × 3 × 5 mm(3) LYSO crystals), suitable for ToF. Dual threshold ToT timing results have been compared to a similar single threshold design, demonstrating that dual threshold ToT performance is far superior to that of single threshold ToT (154 ps versus 418 ps coincidence time resolution for the dual and single threshold cases, respectively). A method of correcting for nonlinearity in dual threshold ToT energy spectra is also demonstrated.

Abstract

We have performed Monte Carlo simulations of the scintillation light transport between adjacent monolithic LYSO crystals that are optically coupled together using coupling media of varying refractive index. The scintillation light from the crystals was read out by SiPM arrays from the large crystal face. Scintillation event positioning results show that this optical coupling technique preserves the shape of the light spread function near and across the interface between the two crystals in order to substantially reduce the edge-artifacts observed in monolithic scintillation crystals, while not degrading the timing performance.

Abstract

Preoperative lymphoscintigraphy (PLS) combined with intraoperative gamma probe (GP) localization is standard procedure for localizing the sentinel lymph nodes (SLN) in melanoma and breast cancer. In this study, we evaluated the ability of a novel intraoperative handheld gamma camera (IHGC) to image SLNs during surgery.The IHGC is a small-field-of-view camera optimized for real-time imaging of lymphatic drainage patterns. Unlike conventional cameras, the IHGC can acquire useful images in a few seconds in a free-running fashion and be moved manually around the patient to find a suitable view of the node. Thirty-nine melanoma and eleven breast cancer patients underwent a modified SLN biopsy protocol in which nodes localized with the GP were imaged with the IHGC. The IHGC was also used to localize additional nodes that could not be found with the GP.The removal of 104 radioactive SLNs was confirmed ex vivo by GP counting. In vivo, the relative node detection sensitivity was 88.5 (82.3, 94.6)% for the IHGC (used in conjunction with the GP) and 94.2 (89.7, 98.7)% for the GP alone, a difference not found to be statistically significant (McNemar test, p = 0.24).Small radioactive SLNs can be visualized intraoperatively using the IHGC with exposure time of 20 s or less, with no significant difference in node detection sensitivity compared to a GP. The IHGC is a useful complement to the GP, especially for SLNs that are difficult to locate with the GP alone.

Abstract

The adoption of solid-state photodetectors for positron emission tomography (PET) system design and the interest in 3D interaction information from PET detectors has lead to an increasing number of readout channels in PET systems. To handle these additional readout channels, PET readout electronics should be simplified to reduce the power consumption, cost, and size of the electronics for a single channel. Pulse-width modulation (PWM), where detector pulses are converted to digital pulses with width proportional to the detected photon energy, promises to simplify PET readout by converting the signals to digital form at the beginning of the processing chain, and allowing a single time-to-digital converter to perform the data acquisition for many channels rather than routing many analogue channels and digitizing in the back end. Integrator based PWM systems, also known as charge-to-time converters (QTCs), are especially compact, reducing the front-end electronics to an op-amp integrator with a resistor discharge, and a comparator. QTCs, however, have a long dead-time during which dark count noise is integrated, reducing the output signal-to-noise ratio. This work presents a QTC based PWM circuit with a gated integrator that shows performance improvements over existing QTC based PWM. By opening and closing an analogue switch on the input of the integrator, the circuit can be controlled to integrate only the portions of the signal with a high signal-to-noise ratio. It also allows for multiplexing different detectors into the same PWM circuit while avoiding uncorrelated noise propagation between photodetector channels. Four gated integrator PWM circuits were built to readout the spatial channels of two position sensitive solid-state photomultiplier (PS-SSPM). Results show a 4 × 4 array 0.9 mm × 0.9 mm × 15 mm of LYSO crystals being identified on the 5 mm × 5 mm PS-SSPM at room temperature with no degradation for twofold multiplexing. In principle, much larger multiplexing ratios are possible, limited only by count rate issues.

Abstract

Advances in solid-state technology have enabled the development of silicon photomultiplier sensor arrays capable of sensing individual photons. Combined with high-frequency time-to-digital converters (TDCs), this technology opens up the prospect of sensors capable of recording with high accuracy both the time and location of each detected photon. Such a capability could lead to significant improvements in imaging accuracy, especially for applications operating with low photon fluxes such as light detection and ranging and positron-emission tomography. The demands placed on on-chip readout circuitry impose stringent trade-offs between fill factor and spatiotemporal resolution, causing many contemporary designs to severely underuse the technology's full potential. Concentrating on the low photon flux setting, this paper leverages results from group testing and proposes an architecture for a highly efficient readout of pixels using only a small number of TDCs. We provide optimized design instances for various sensor parameters and compute explicit upper and lower bounds on the number of TDCs required to uniquely decode a given maximum number of simultaneous photon arrivals. To illustrate the strength of the proposed architecture, we note a typical digitization of a 60 × 60 photodiode sensor using only 142 TDCs. The design guarantees registration and unique recovery of up to four simultaneous photon arrivals using a fast decoding algorithm. By contrast, a cross-strip design requires 120 TDCs and cannot uniquely decode any simultaneous photon arrivals. Among other realistic simulations of scintillation events in clinical positron-emission tomography, the above design is shown to recover the spatiotemporal location of 99.98% of all detected photons.

Abstract

Nuclear medicine imaging detectors are commonly multiplexed to reduce the number of readout channels. Because the underlying detector signals have a sparse representation, sparse recovery methods such as compressed sensing may be used to develop new multiplexing schemes. Random methods may be used to create sensing matrices that satisfy the restricted isometry property. However, the restricted isometry property provides little guidance for developing multiplexing networks with good signal-to-noise recovery capability. In this work, we describe compressed sensing using a maximum likelihood framework and develop a new method for constructing multiplexing (sensing) matrices that can recover signals more accurately in a mean square error sense compared to sensing matrices constructed by random construction methods. Signals can then be recovered by maximum likelihood estimation constrained to the support recovered by either greedy l? iterative algorithms or l?-norm minimization techniques. We show that this new method for constructing and decoding sensing matrices recovers signals with 4%-110% higher SNR than random Gaussian sensing matrices, up to 100% higher SNR than partial DCT sensing matrices 50%-2400% higher SNR than cross-strip multiplexing, and 22%-210% higher SNR than Anger multiplexing for photoelectric events.

Abstract

The processing speed for positron emission tomography (PET) image reconstruction has been greatly improved in recent years by simply dividing the workload to multiple processors of a graphics processing unit (GPU). However, if this strategy is generalized to a multi-GPU cluster, the processing speed does not improve linearly with the number of GPUs. This is because large data transfer is required between the GPUs after each iteration, effectively reducing the parallelism. This paper proposes a novel approach to reformulate the maximum likelihood expectation maximization (MLEM) algorithm so that it can scale up to many GPU nodes with less frequent inter-node communication. While being mathematically different, the new algorithm maximizes the same convex likelihood function as MLEM, thus converges to the same solution. Experiments on a multi-GPU cluster demonstrate the effectiveness of the proposed approach.

Abstract

Precise timing resolution is crucial for applications requiring photon time-of-flight (ToF) information such as ToF positron emission tomography (PET). Silicon photomultipliers (SiPM) for PET, with their high output capacitance, are known to require custom preamplifiers to optimize timing performance. In this paper, we describe simple alternative front-end electronics based on a commercial low-noise RF preamplifier and methods that have been implemented to achieve excellent timing resolution. Two radiation detectors with L(Y)SO scintillators coupled to Hamamatsu SiPMs (MPPC S10362-33-050C) and front-end electronics based on an RF amplifier (MAR-3SM+), typically used for wireless applications that require minimal additional circuitry, have been fabricated. These detectors were used to detect annihilation photons from a Ge-68 source and the output signals were subsequently digitized by a high speed oscilloscope for offline processing. A coincident resolving time (CRT) of 147 ± 3 ps FWHM and 186 ± 3 ps FWHM with 3 × 3 × 5 mm(3) and with 3 × 3 × 20 mm(3) LYSO crystal elements were measured, respectively. With smaller 2 × 2 × 3 mm(3) LSO crystals, a CRT of 125 ± 2 ps FWHM was achieved with slight improvement to 121 ± 3 ps at a lower temperature (15° C). Finally, with the 20 mm length crystals, a degradation of timing resolution was observed for annihilation photon interactions that occur close to the photosensor compared to shallow depth-of-interaction (DOI). We conclude that commercial RF amplifiers optimized for noise, besides their ease of use, can produce excellent timing resolution comparable to best reported values acquired with custom readout electronics. On the other hand, as timing performance degrades with increasing photon DOI, a head-on detector configuration will produce better CRT than a side-irradiated setup for longer crystals.

Abstract

We estimated reader-dependent variability of region of interest (ROI) analysis and evaluated its impact on preclinical quantitative molecular imaging. To estimate reader variability, we used five independent image datasets acquired each using microPET and multispectral fluorescence imaging (MSFI). We also selected ten experienced researchers who utilize molecular imaging in the same environment that they typically perform their own studies. Nine investigators blinded to the data type completed the ROI analysis by drawing ROIs manually that delineate the tumor regions to the best of their knowledge and repeated the measurements three times, non-consecutively. Extracted mean intensities of voxels within each ROI are used to compute the coefficient of variation (CV) and characterize the inter- and intra-reader variability. The impact of variability was assessed through random samples iterated from normal distributions for control and experimental groups on hypothesis testing and computing statistical power by varying subject size, measured difference between groups and CV. The results indicate that inter-reader variability was 22.5% for microPET and 72.2% for MSFI. Additionally, mean intra-reader variability was 10.1% for microPET and 26.4% for MSFI. Repeated statistical testing showed that a total variability of CV < 50% may be needed to detect differences < 50% between experimental and control groups when six subjects (n = 6) or more are used and statistical power is adequate (80%). Surprisingly high variability has been observed mainly due to differences in the ROI placement and geometry drawn between readers, which may adversely affect statistical power and erroneously lead to negative study outcomes.

Influence of temperature and bias voltage on the performance of a high resolution PET detector built with position sensitive avalanche photodiodesJOURNAL OF INSTRUMENTATIONVandenbroucke, A., McLaughlin, T. J., Levin, C. S.2012; 7

Abstract

This paper studied PET intrinsic spatial resolution and contrast recovery improvement for PET/MRI dual modality systems. A Monte Carlo simulation tool was developed to study positron diffusion in tissues with and without a magnetic field for six commonly used isotopes ((18)F, (11)C, (13)N, (15)O, (68)Ga and (82)Rb). A convolution process was implemented to investigate PET intrinsic spatial resolution, taking into account three factors: positron diffusion range, collinear photon annihilation and finite detector element width. The resolution improvement was studied quantitatively as a function of magnetic field strength for three PET system configurations (whole-body, brain-dedicated and small-animal PET). When the magnetic field strength increases up to 10 T, the system spatial resolution in directions orthogonal to the field for (15)O, (68)Ga and (82)Rb is comparable to that of (18)F without the magnetic field. Beyond 10 T, no significant improvement of spatial resolution was observed. In addition, the modulation transfer function was studied to predict the intrinsic contrast recovery improvement for several existing and promising PET/MRI configurations.

Abstract

The ability of PET to visualize and quantify regions of low concentration of PET tracer representing subtle cellular and molecular signatures of disease depends on relatively complex biochemical, biologic, and physiologic factors that are challenging to control, as well as on instrumentation performance parameters that are, in principle, still possible to improve on. Thus, advances to the latter can somewhat offset barriers of the former. PET system performance parameters such as spatial resolution, contrast resolution, and photon sensitivity contribute significantly to PET's ability to visualize and quantify lower concentrations of signal in the presence of background. In this report we present some technology innovations under investigation toward improving these PET system performance parameters. We focus particularly on a promising advance known as 3-dimensional position-sensitive detectors, which are detectors capable of distinguishing and measuring the position, energy, and arrival time of individual interactions of multi-interaction photon events in 3 dimensions. If successful, these new strategies enable enhancements such as the detection of fewer diseased cells in tissue or the ability to characterize lower-abundance molecular targets within cells. Translating these advanced capabilities to the clinic might allow expansion of PET's roles in disease management, perhaps to earlier stages of disease. In preclinical research, such enhancements enable more sensitive and accurate studies of disease biology in living subjects.

Abstract

List-mode processing is an efficient way of dealing with the sparse nature of positron emission tomography (PET) data sets and is the processing method of choice for time-of-flight (ToF) PET image reconstruction. However, the massive amount of computation involved in forward projection and backprojection limits the application of list-mode reconstruction in practice, and makes it challenging to incorporate accurate system modeling.The authors present a novel formulation for computing line projection operations on graphics processing units (GPUs) using the compute unified device architecture (CUDA) framework, and apply the formulation to list-mode ordered-subsets expectation maximization (OSEM) image reconstruction. Our method overcomes well-known GPU challenges such as divergence of compute threads, limited bandwidth of global memory, and limited size of shared memory, while exploiting GPU capabilities such as fast access to shared memory and efficient linear interpolation of texture memory. Execution time comparison and image quality analysis of the GPU-CUDA method and the central processing unit (CPU) method are performed on several data sets acquired on a preclinical scanner and a clinical ToF scanner.When applied to line projection operations for non-ToF list-mode PET, this new GPU-CUDA method is >200 times faster than a single-threaded reference CPU implementation. For ToF reconstruction, we exploit a ToF-specific optimization to improve the efficiency of our parallel processing method, resulting in GPU reconstruction >300 times faster than the CPU counterpart. For a typical whole-body scan with 75?×?75?×?26 image matrix, 40.7 million LORs, 33 subsets, and 3 iterations, the overall processing time is 7.7 s for GPU and 42 min for a single-threaded CPU. Image quality and accuracy are preserved for multiple imaging configurations and reconstruction parameters, with normalized root mean squared (RMS) deviation less than 1% between CPU and GPU-generated images for all cases.A list-mode ToF OSEM library was developed on the GPU-CUDA platform. Our studies show that the GPU reformulation is considerably faster than a single-threaded reference CPU method especially for ToF processing, while producing virtually identical images. This new method can be easily adapted to enable more advanced algorithms for high resolution PET reconstruction based on additional information such as depth of interaction (DoI), photon energy, and point spread functions (PSFs).

Abstract

Positron emission tomography systems are best described by a linear shift-varying model. However, image reconstruction often assumes simplified shift-invariant models to the detriment of image quality and quantitative accuracy. We investigated a shift-varying model of the geometrical system response based on an analytical formulation. The model was incorporated within a list-mode, fully 3D iterative reconstruction process in which the system response coefficients are calculated online on a graphics processing unit (GPU). The implementation requires less than 512 Mb of GPU memory and can process two million events per minute (forward and backprojection). For small detector volume elements, the analytical model compared well to reference calculations. Images reconstructed with the shift-varying model achieved higher quality and quantitative accuracy than those that used a simpler shift-invariant model. For an 8 mm sphere in a warm background, the contrast recovery was 95.8% for the shift-varying model versus 85.9% for the shift-invariant model. In addition, the spatial resolution was more uniform across the field-of-view: for an array of 1.75 mm hot spheres in air, the variation in reconstructed sphere size was 0.5 mm RMS for the shift-invariant model, compared to 0.07 mm RMS for the shift-varying model.

Abstract

In this work, we propose a new method to increase the accuracy of identifying true coincidence events for positron emission tomography (PET). This approach requires 3-D detectors with the ability to position each photon interaction in multi-interaction photon events. When multiple interactions occur in the detector, the incident direction of the photon can be estimated using the Compton scatter kinematics (Compton Collimation). If the difference between the estimated incident direction of the photon relative to a second, coincident photon lies within a certain angular range around colinearity, the line of response between the two photons is identified as a true coincidence and used for image reconstruction. We present an algorithm for choosing the incident photon direction window threshold that maximizes the noise equivalent counts of the PET system. For simulated data, the direction window removed 56%-67% of random coincidences while retaining > 94% of true coincidences from image reconstruction as well as accurately extracted 70% of true coincidences from multiple coincidences.

Abstract

We investigated the feasibility of designing an Anger-logic PET detector module using large-area high-gain avalanche photodiodes (APDs) for a brain-dedicated PET/MRI system. Using Monte Carlo simulations, we systematically optimized the detector design with regard to the scintillation crystal, optical diffuser, surface treatment, layout of large-area APDs, and signal-to-noise ratio (SNR, defined as the 511 keV photopeak position divided by the standard deviation of noise floor in an energy spectrum) of the APD devices. A detector prototype was built comprising an 8 × 8 array of 2.75 × 3.00 × 20.0 mm3 LYSO (lutetium-yttrium-oxyorthosilicate) crystals and a 22.0 × 24.0 × 9.0 mm3 optical diffuser. From the four designs of the optical diffuser tested, two designs employing a slotted diffuser are able to resolve all 64 crystals within the block with good uniformity and peak-to-valley ratio. Good agreement was found between the simulation and experimental results. For the detector employing a slotted optical diffuser, the energy resolution of the global energy spectrum after normalization is 13.4 ± 0.4%. The energy resolution of individual crystals varies between 11.3 ± 0.3% and 17.3 ± 0.4%. The time resolution varies between 4.85 ± 0.04 (center crystal), 5.17 ± 0.06 (edge crystal), and 5.18 ± 0.07 ns (corner crystal). The generalized framework proposed in this work helps to guide the design of detector modules for selected PET system configurations, including scaling the design down to a preclinical PET system, scaling up to a whole-body clinical scanner, as well as replacing APDs with other novel photodetectors that have higher gain or SNR such as silicon photomultipliers.

Abstract

This paper investigates the performance of 1 mm resolution cadmium zinc telluride (CZT) detectors for positron emission tomography (PET) capable of positioning the 3D coordinates of individual 511 keV photon interactions. The detectors comprise 40 mm × 40 mm × 5 mm monolithic CZT crystals that employ a novel cross-strip readout with interspersed steering electrodes to obtain high spatial and energy resolution. The study found a single anode FWHM energy resolution of 3.06 ± 0.39% at 511 keV throughout most of the detector volume. Improved resolution is expected with properly shielded front-end electronics. Measurements made using a collimated beam established the efficacy of the steering electrodes in facilitating enhanced charge collection across anodes, as well as a spatial resolution of 0.44 ± 0.07 mm in the direction orthogonal to the electrode planes. Finally, measurements based on coincidence electronic collimation yielded a point spread function with 0.78 ± 0.10 mm FWHM, demonstrating 1 mm spatial resolution capability transverse to the anodes-as expected from the 1 mm anode pitch. These findings indicate that the CZT-based detector concept has excellent performance and shows great promise for a high-resolution PET system.

Abstract

This study investigates the physical limitations involved in the extraction of accurate timing information from pixellated scintillation detectors for positron emission tomography (PET). Accurate physical modeling of the scintillation detection process, from scintillation light generation through detection, is devised and performed for varying detector attributes, such as the crystal element length, light yield, decay time and surface treatment. The dependence of light output and time resolution on these attributes, as well as on the photon interaction depth (DoI) of the annihilation quanta within the crystal volume, is studied and compared with experimental results. A theoretical background which highlights the importance of different time blurring factors for instantaneous ('ideal') and exponential ('realistic') scintillation decay is developed and compared with simulated data. For the case of a realistic scintillator, our experimental and simulation findings suggest that dependence of detector performance on DoI is more evident for crystal elements with rough ('as cut') compared to polished surfaces (maximum observed difference of 64% (25%) and 22% (19%) in simulation (measurement) for light output and time resolution, respectively). Furthermore we observe distinct trends of the detector performance dependence on detector element length and surface treatment. For short crystals (3 × 3 × 5 mm(3)) an improvement in light output and time resolution for 'as cut' compared to polished crystals is observed (3% (7%) and 9% (9%) for simulation (measurement), respectively). The trend is reversed for longer crystals (3 × 3 × 20 mm(3)) and an improvement in light output and time uncertainty for polished compared to 'as cut' crystals is observed (36% (6%) and 40% (20%) for simulation (measurement), respectively). The results of this study are used to guide the design of PET detectors with combined time of flight (ToF) and DoI features.

Abstract

We are developing a dual panel breast-dedicated positron emission tomography (PET) system using LSO scintillators coupled to position sensitive avalanche photodiodes (PSAPD). The charge output is amplified and read using NOVA RENA-3 ASICs. This paper shows that the coincidence timing resolution of the RENA-3 ASIC can be improved using certain list-mode calibrations. We treat the calibration problem as a convex optimization problem and use the RENA-3's analog-based timing system to correct the measured data for time dispersion effects from correlated noise, PSAPD signal delays and varying signal amplitudes. The direct solution to the optimization problem involves a matrix inversion that grows order (n(3)) with the number of parameters. An iterative method using single-coordinate descent to approximate the inversion grows order (n). The inversion does not need to run to convergence, since any gains at high iteration number will be low compared to noise amplification. The system calibration method is demonstrated with measured pulser data as well as with two LSO-PSAPD detectors in electronic coincidence. After applying the algorithm, the 511 keV photopeak paired coincidence time resolution from the LSO-PSAPD detectors under study improved by 57%, from the raw value of 16.3 ±0.07 ns full-width at half-maximum (FWHM) to 6.92 ±0.02 ns FWHM ( 11.52 ±0.05 ns to 4.89 ±0.02 ns for unpaired photons).

Abstract

An optical electrical model which studies the response of Si-based single photon counting arrays, specifically silicon photomultipliers (SiPMs), to scintillation light has been developed and validated with analytically derived and experimental data. The scintillator-photodetector response in terms of relative pulse height, 10%-90% rise/decay times to light stimuli of different rise times (ranging from 0.1 to 5 ns) and decay times (ranging from 1 to 50 ns), as well as for different decay times of the photodetector are compared in theory and simulation. A measured detector response is used as a reference to further validate the model and the results show a mean deviation of simulated over measured values of 1%.

Abstract

A 1 mm(3) resolution clinical positron emission tomography (PET) system employing 4608 position-sensitive avalanche photodiodes (PSAPDs) is under development. This paper describes a detector multiplexing technique that simplifies the readout electronics and reduces the density of the circuit board design. The multiplexing scheme was validated using a simulation framework that models the PSAPDs and front-end multiplexing circuits to predict the signal-to-noise ratio and flood histogram performance. Two independent experimental setups measured the energy resolution, time resolution, crystal identification ability and count rate both with and without multiplexing. With multiplexing, there was no significant degradation in energy resolution, time resolution and count rate. There was a relative 6.9 ± 1.0% and 9.4 ± 1.0% degradation in the figure of merit that characterizes the crystal identification ability observed in the measured and simulated ceramic-mounted PSAPD module flood histograms, respectively.

Abstract

This study aims to address design considerations of a high resolution, high sensitivity positron emission tomography scanner dedicated to breast imaging.The methodology uses a detailed Monte Carlo model of the system structures to obtain a quantitative evaluation of several performance parameters. Special focus was given to the effect of dense mechanical structures designed to provide mechanical robustness and thermal regulation to the minuscule and temperature sensitive detectors.For the energies of interest around the photopeak (450-700 keV energy window), the simulation results predict a 6.5% reduction in the single photon detection efficiency and a 12.5% reduction in the coincidence photon detection efficiency in the case that the mechanical structures are interspersed between the detectors. However for lower energies, a substantial increase in the number of detected events (approximately 14% and 7% for singles at a 100-200 keV energy window and coincidences at a lower energy threshold of 100 keV, respectively) was observed with the presence of these structures due to backscatter. The number of photon events that involve multiple interactions in various crystal elements is also affected by the presence of the structures. For photon events involving multiple interactions among various crystal elements, the coincidence photon sensitivity is reduced by as much as 20% for a point source at the center of the field of view. There is no observable effect on the intrinsic and the reconstructed spatial resolution and spatial resolution uniformity.Mechanical structures can have a considerable effect on system sensitivity, especially for systems processing multi-interaction photon events. This effect, however, does not impact the spatial resolution. Various mechanical structure designs are currently under evaluation in order to achieve optimum trade-off between temperature stability, accurate detector positioning, and minimum influence on system performance.

Abstract

We present the most recent advances in photo-detector design employed in time of flight positron emission tomography (ToF-PET). PET is a molecular imaging modality that collects pairs of coincident (temporally correlated) annihilation photons emitted from the patient body. The annihilation photon detector typically comprises a scintillation crystal coupled to a fast photo-detector. ToF information provides better localization of the annihilation event along the line formed by each detector pair, resulting in an overall improvement in signal to noise ratio (SNR) of the reconstructed image. Apart from the demand for high luminosity and fast decay time of the scintillation crystal, proper design and selection of the photo-detector and methods for arrival time pick-off are a prerequisite for achieving excellent time resolution required for ToF-PET. We review the two types of photo-detectors used in ToF-PET: photomultiplier tubes (PMTs) and silicon photo-multipliers (SiPMs) with a special focus on SiPMs.

Abstract

Performance of a new high resolution PET detection concept is presented. In this new concept, annihilation radiation enters the scintillator detectors edge-on. Each detector module comprises two 8 × 8 LYSO scintillator arrays of 0.91 × 0.91 × 1 mm(3) crystals coupled to two position-sensitive avalanche photodiodes (PSAPDs) mounted on a flex circuit. Appropriate crystal segmentation allows the recording of all three spatial coordinates of the interaction(s) simultaneously with submillimeter resolution. We report an average energy resolution of 14.6 ± 1.7% for 511 keV photons at FWHM. Coincident time resolution was determined to be 2.98 ± 0.13 ns FWHM on average. The coincidence point spread function (PSF) has an average FWHM of 0.837 ± 0.049 mm (using a 500 ?m spherical source) and is uniform across the arrays. Both PSF and coincident time resolution degrade when Compton interactions are included in the data. Different blurring factors were evaluated theoretically, resulting in a calculated PSF of 0.793 mm, in good agreement with the measured value.

Abstract

The authors' laboratory is developing a dual-panel, breast-dedicated PET system. The detector panels are built from dual-LSO-position-sensitive avalanche photodiode (PSAPD) modules-units holding two 8 x 8 arrays of 1 mm3 LSO crystals, where each array is coupled to a PSAPD. When stacked to form an imaging volume, these modules are capable of recording the 3-D coordinates of individual interactions of a multiple-interaction photon event (MIPE). The small size of the scintillation crystal elements used increases the likelihood of photon scattering between crystal arrays. In this article, the authors investigate how MIPEs impact the system photon sensitivity, the data acquisition scheme, and the quality and quantitative accuracy of reconstructed PET images.A Monte Carlo simulated PET scan using the dual-panel system was performed on a uniformly radioactive phantom for the photon sensitivity study. To establish the impact of MIPEs on a proposed PSAPD multiplexing scheme, experimental data were collected from a dual-LSO-PSAPD module edge-irradiated with a 22Na point source, the data were compared against simulation data based on an identical setup. To assess the impact of MIPEs on the dual-panel PET images, a simulated PET of a phantom comprising a matrix of hot spherical radiation sources of varying diameters immersed in a warm background was performed. The list-mode output data were used for image reconstruction, where various methods were used for estimating the location of the first photon interaction in MIPEs for more accurate line of response positioning. The contrast recovery coefficient (CRC), contrast to noise ratio (CNR), and the full width at half maximum spatial resolution of the spheres in the reconstructed images were used as figures of merit to facilitate comparison.Compared to image reconstruction employing only events with interactions confined to one LSO array, a potential single photon sensitivity gain of > 46.9% (> 115.7% for coincidence) was noted for a uniform phantom when MIPEs with summed-energy falling within a +/- 12% window around the photopeak were also included. Both experimental and simulation data demonstrate that < 0.4% of the events whose summed-energy deposition falling within that energy window interacted with both crystal arrays within the same dual-LSO-PSAPD module. This result establishes the feasibility of a proposed multiplexed readout of analog output signals of the two PSAPDs within each module. Using MIPEs with summed-energy deposition within the 511 keV +/- 12% photopeak window and a new method for estimating the location of the first photon interaction in MIPEs, the corresponding reconstructed image exhibited a peak CNR of 7.23 for the 8 mm diameter phantom spheres versus a CNR of 6.69 from images based solely on single LSO array interaction events. The improved system photon sensitivity could be exploited to reduce the scan time by up to approximately 10%, while still maintaining image quality comparable to that achieved if MIPEs were excluded.MIPE distribution in the detectors allows the proposed photodetector multiplexing arrangement without significant information loss. Furthermore, acquiring MIPEs can enhance system photon sensitivity and improve PET image CNR and CRC. The system under development can therefore competently acquire and analyze MIPEs and produce high-resolution PET images.

Abstract

Positron emission tomography (PET) is used in the clinic and in vivo small animal research to study molecular processes associated with diseases such as cancer, heart disease, and neurological disorders, and to guide the discovery and development of new treatments. This paper reviews current challenges of advancing PET technology and some of newly developed PET detectors and systems. The paper focuses on four aspects of PET instrumentation: high photon detection sensitivity; improved spatial resolution; depth-of-interaction (DOI) resolution and time-of-flight (TOF). Improved system geometry, novel non-scintillator based detectors, and tapered scintillation crystal arrays are able to enhance the photon detection sensitivity of a PET system. Several challenges for achieving high resolution with standard scintillator-based PET detectors are discussed. Novel detectors with 3-D positioning capability have great potential to be deployed in PET for achieving spatial resolution better than 1 mm, such as cadmium-zinc-telluride (CZT) and position-sensitive avalanche photodiodes (PSAPDs). DOI capability enables a PET system to mitigate parallax error and achieve uniform spatial resolution across the field-of-view (FOV). Six common DOI designs, as well as advantages and limitations of each design, are discussed. The availability of fast scintillation crystals such as LaBr(3), and the silicon photomultiplier (SiPM) greatly advances TOF-PET development. Recent instrumentation and initial results of clinical trials are briefly presented. If successful, these technology advances, together with new probe molecules, will substantially enhance the molecular sensitivity of PET and thus increase its role in preclinical and clinical research as well as evaluating and managing disease in the clinic.

Abstract

We studied the performance of a dual-panel positron emission tomography (PET) camera dedicated to breast cancer imaging using Monte Carlo simulation. The proposed system consists of two 4 cm thick 12 x 15 cm(2) area cadmium zinc telluride (CZT) panels with adjustable separation, which can be put in close proximity to the breast and/or axillary nodes. Unique characteristics distinguishing the proposed system from previous efforts in breast-dedicated PET instrumentation are the deployment of CZT detectors with superior spatial and energy resolution, using a cross-strip electrode readout scheme to enable 3D positioning of individual photon interaction coordinates in the CZT, which includes directly measured photon depth-of-interaction (DOI), and arranging the detector slabs edge-on with respect to incoming 511 keV photons for high photon sensitivity. The simulation results show that the proposed CZT dual-panel PET system is able to achieve superior performance in terms of photon sensitivity, noise equivalent count rate, spatial resolution and lesion visualization. The proposed system is expected to achieve approximately 32% photon sensitivity for a point source at the center and a 4 cm panel separation. For a simplified breast phantom adjacent to heart and torso compartments, the peak noise equivalent count (NEC) rate is predicted to be approximately 94.2 kcts s(-1) (breast volume: 720 cm(3) and activity concentration: 3.7 kBq cm(-3)) for a approximately 10% energy window around 511 keV and approximately 8 ns coincidence time window. The system achieves 1 mm intrinsic spatial resolution anywhere between the two panels with a 4 cm panel separation if the detectors have DOI resolution less than 2 mm. For a 3 mm DOI resolution, the system exhibits excellent sphere resolution uniformity (sigma(rms)/mean) < or = 10%) across a 4 cm width FOV. Simulation results indicate that the system exhibits superior hot sphere visualization and is expected to visualize 2 mm diameter spheres with a 5:1 activity concentration ratio within roughly 7 min imaging time. Furthermore, we observe that the degree of spatial resolution degradation along the direction orthogonal to the two panels that is typical of a limited angle tomography configuration is mitigated by having high-resolution DOI capabilities that enable more accurate positioning of oblique response lines.

Abstract

A new magnetic resonance imaging (MRI)-compatible positron emission tomography (PET) detector design is being developed that uses electro-optical coupling to bring the amplitude and arrival time information of high-speed PET detector scintillation pulses out of an MRI system. The electro-optical coupling technology consists of a magnetically insensitive photodetector output signal connected to a nonmagnetic vertical cavity surface emitting laser (VCSEL) diode that is coupled to a multimode optical fiber. This scheme essentially acts as an optical wire with no influence on the MRI system. To test the feasibility of this approach, a lutetium-yttrium oxyorthosilicate crystal coupled to a single pixel of a solid-state photomultiplier array was placed in coincidence with a lutetium oxyorthosilicate crystal coupled to a fast photomultiplier tube with both the new nonmagnetic VCSEL coupling and the standard coaxial cable signal transmission scheme. No significant change was observed in 511 keV photopeak energy resolution and coincidence time resolution. This electro-optical coupling technology enables an MRI-compatible PET block detector to have a reduced electromagnetic footprint compared with the signal transmission schemes deployed in the current MRI/PET designs.

Abstract

We are studying two new detector technologies that directly measure the three-dimensional coordinates of 511 keV photon interactions for high-resolution positron emission tomography (PET) systems designed for small animal and breast imaging. These detectors are based on (1) lutetium oxyorthosilicate (LSO) scintillation crystal arrays coupled to position-sensitive avalanche photodiodes (PSAPD) and (2) cadmium zinc telluride (CZT). The detectors have excellent measured 511 keV photon energy resolutions (=12% FWHM for LSO-PSAPD and =3% for CZT) and good coincidence time resolutions (2 ns FWHM for LSO-PSAPD and 8 ns for CZT). The goal is to incorporate the detectors into systems that will achieve 1 mm(3) spatial resolution ( approximately 1 mm(3), uniform throughout the field of view (FOV)), with excellent contrast resolution as well. In order to realize 1 mm(3) spatial resolution with high signal-to-noise ratio (SNR), it is necessary to significantly boost coincidence photon detection efficiency (referred to as photon sensitivity). To facilitate high photon sensitivity in the proposed PET system designs, the detector arrays are oriented 'edge-on' with respect to incoming 511 keV annihilation photons and arranged to form a compact FOV with detectors very close to, or in contact with, the subject tissues. In this paper, we used Monte Carlo simulation to study various factors that limit the photon sensitivity of a high-resolution PET system dedicated to small animal imaging. To optimize the photon sensitivity, we studied several possible system geometries for a fixed 8 cm transaxial and 8 cm axial FOV. We found that using rectangular-shaped detectors arranged into a cylindrical geometry does not yield the best photon sensitivity. This is due to the fact that forming rectangular-shaped detectors into a ring produces significant wedge-shaped inter-module gaps, through which Compton-scattered photons in the detector can escape. This effect limits the center point source photon sensitivity to <6% for a cylindrical system with rectangular-shaped blocks, 8 cm diameter and 8 cm axial FOV, and a 350-650 keV energy window setting. On the other hand, if the proposed rectangular-shaped detectors are arranged into an 8 x 8 x 8 cm(3) FOV box configuration (four detector panels), there are only four inter-module gaps and the favorable distribution of these gaps yields >8% photon sensitivity for the LSO-PSAPD box configuration and >15% for CZT box geometry, using a 350-650 keV energy window setting. These simulation results compare well with analytical estimations. The trend is different for a clinical whole-body PET system that uses conventional LSO-PMT block detectors with larger crystal elements. Simulations predict roughly the same sensitivity for both box and cylindrical detector configurations. This results from the fact that a large system diameter (>80 cm) results in relatively small inter-module gaps in clinical whole-body PET. In addition, the relatively large block detectors (typically >5 x 5 cm(2) cross-sectional area) and large crystals (>4 x 4 x 20 mm(3)) enable a higher fraction of detector scatter photons to be absorbed compared to a small animal system. However, if the four detector sides (panels) of a box-shaped system geometry are configured to move with respect to each other, to better fit the transaxial FOV to the actual size of the object to be imaged, a significant increase in photon sensitivity is possible. Simulation results predict a 60-100% relative increase of photon sensitivity for the proposed small animal PET box configurations and >60% increase for a clinical whole-body system geometry. Thus, simulation results indicate that for a PET system built from rectangular-shaped detector modules, arranging them into a box-shaped system geometry may help us to significantly boost photon sensitivity for both small animal and clinical PET systems.

Abstract

We have developed a miniature scintillation camera to be used in surgical cancer staging. The availability of such a compact hand-held gamma camera may in certain cases improve localization of the sentinel lymph node and reduce the duration of a surgical breast cancer staging procedure. We have investigated image processing algorithms applied to planar images that may improve node detection capabilities for breast cancer staging. We have also studied contrast enhancement methods that may be able to identify nodes that would otherwise be missed. Exposure duration for a given camera position can be adaptively shortened or increased by using an optical flow algorithm to estimate camera motion with respect to the current frame. By determining if the camera is in motion or not, the exposure time may be increased to allow more image counts to accumulate at a given camera position. Adaptive exposure time may improve the ease of use of the hand-held camera, and allow regions of interest to be imaged more effectively. We feel that these image processing techniques can improve the utility of a hand-held gamma ray imager for sentinel lymph node detection during breast cancer staging.

Abstract

We are developing a novel, portable dual-panel positron emission tomography (PET) camera dedicated to breast cancer imaging. With a sensitive area of approximately 150 cm(2), this camera is based on arrays of lutetium oxyorthosilicate (LSO) crystals (1x1x3 mm(3)) coupled to 11x11-mm(2) position-sensitive avalanche photodiodes (PSAPD). GATE open source software was used to perform Monte Carlo simulations to optimize the parameters for the camera design. The noise equivalent counting (NEC) rate, together with the true, scatter, and random counting rates were simulated at different time and energy windows. Focal plane tomography (FPT) was used for visualizing the tumors at different depths between the two detector panels. Attenuation and uniformity corrections were applied to images.

Abstract

We are developing a high resolution, high sensitivity PET camera dedicated to breast cancer imaging. We are studying two novel detector technologies for this imaging system: a scintillation detector comprising layers of small lutetium oxyorthosilicate (LSO) crystals coupled to new position sensitive avalanche photodiodes (PSAPDs), and a pure semiconductor detector comprising cadmium zinc telluride (CZT) crystal slabs with thin anode and cathode strips deposited in orthogonal directions on either side of each slab. Both detectors achieve 1 mm spatial resolution with 3-5 mm directly measured photon interaction depth resolution, which promotes uniform reconstructed spatial resolution throughout a compact, breast-size field of view. Both detector types also achieve outstanding energy resolution (<3% and <12%, respectively for LSO-PSAPD and CZT at 511 keV). This paper studies the effects that this excellent energy resolution has on the expected system performance. Results indicate the importance that high energy resolution and narrow energy window settings have in reducing background random as well as scatter coincidences without compromising statistical quality of the dedicated breast PET data. Simulations predict that using either detector type the excellent performance and novel arrangement of these detectors proposed for the system facilitate approximately 20% instrument sensitivity at the system center and a peak noise-equivalent count rate of >4 kcps for 200 microCi in a simulated breast phantom.